Improving the quality of interpersonal communication skills of clinical officers at Moi Teaching and Referral Hospital, Eldoret, Kenya

Abstract

The way health care providers communicate has been linked to proximate outcomes such as patient satisfaction and recall, and to final outcomes, such as client compliance with treatment regimes and improved health results (Kurtz, Silverman & Draper, 1998). The goal of this study was to identify gaps in interpersonal skills of Clinical Officers at the outpatient department (OPD) of Moi Teaching & Referral Hospital (MTRH), Eldoret, Kenya, and institute mechanisms to close the gaps in order to improve the quality of services offered by the Clinical Officers. Six clinical officers were randomly selected to represent the 20 clinical officers that were practicing at the OPD of MTRH. Six consultations from these six clinical officers were then randomly selected and audiotaped for further analysis. The clients whose consultations were audiotaped were interviewed after the consultation to assess their level of satisfaction and impression on the quality of the consultation. A total of 36 clients were interviewed. The findings from the audiotaped consultations and the exit interviews were analyzed and used to determine the state of the clinical officers’ interpersonal communication skills. A gap in their interpersonal communication skills was identified, using a modified Calgary-Cambridge Checklist that assesses the practice of certain critical tasks during a consultation by the clinician. In total, only 13 (22.81%) of the possible 57 tasks were performed competently by all the clinical officers in the study. The performance of the clinical officers within the different task groups also varied. The four task groups included initiating the session, gathering information, building relationship (facilitating patient’s involvement), and explaining and planning. The tasks at which the Clinical Officers performed competently can be categorized as ‘doctor-centred’, mainly involving ‘history taking’. The tasks at which the Clinical Officers did not perform well at were mainly the patient-centred tasks, related to involving the patient in decision-making, as well as taking into consideration the patient’s needs while conducting the consultation. The root causes of the performance gap were identified and categorized according to the performance factors (USAID PICG, 2003). For instance, one of the root causes identified was that the Clinical Officers have not received training on interpersonal communication skills and counselling. Appropriate interventions to address these root causes were then identified, so as to improve the quality of interpersonal communication skills among the clinical officers. For instance, to address the lack of knowledge and skills on interpersonal communication skills and counselling, structured training coupled with appropriate feedback can be offered to the Clinical Officers.